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Attorney General files lawsuit against six large insurance companies alleging price-fixingPosted by By Rebecca Mowbray November 07, 2007 7:44PM__________________
The suit, filed in conjunction with several outside law firms deep in Katrina litigation, is based on the work of an ongoing investigation by the Louisiana Attorney General, who lost his re-election bid in the October 20 primary. It says that these groups conspired to manipulate commerce for their own enrichment "by rigging the value of policyholder claims and raiding the premiums held in trust by their companies" and that companies "coerced their policyholders into settling their claims of damages for less than their value by editing engineering reports, by delaying payment and by forcing policyholders to litigate claims to receive full value." Bob Hartwig, an economist who is president of the Insurance Information Institute trade group, said that Foti's accusations are baseless. "To allege that insurers act collusively in the settlement of claims is an accusation that has no merit whatsoever," Hartwig said. "Insurers operate independently from each other in settling claims. They do not consult with one another, and they adjust those claims according to their individual contracts with their customers." In Louisiana, insurers paid out $28 billion on 1.2 million claims of all types from Hurricanes Katrina and Rita. "Those are very substantial numbers. Much of the rebuilding that's going on in Louisiana today is being done with insurance money," Hartwig said.
The suit names State Farm Fire and
Casualty Co. and Allstate Insurance Co., Louisiana's two largest
residential insurers; Farmers Insurance Exchange, the state's fifth
largest homeowners insurance company; Standard Fire Insurance Co, better
known as Travelers, the state's seventh largest homeowners insurer;
military insurer USAA Casualty Insurance Co., the eighth largest
homeowners company and tiny Lafayette Insurance Co., a division of
United Fire Group. Many of the companies named in the suit could not be reached for comment Wednesday. McKinsey officials said the company doesn't comment on anything related to client work. Allstate and Travelers officials said they couldn't comment because they hadn't seen the suit, as did State Farm, which also said it stands by its claims-handling procedures. "We haven't seen the suit. What I can say is that we handle each claim individually based on the merits of the claims based on our contracts with our policyholders," State Farm spokesman Fraser Engerman said. "We pay what we owe."
USAA spokesman David Snowden said that
lawyers are reviewing the suit. "USAA's claims practices are based on a
foundation of ethics, fairness and integrity. Since Hurricane Katrina,
we've worked with our members to individually resolve more than 20,000
claims in Louisiana," Snowden said. USAA is owned by its members, who
are military personnel and their families.
By using claims processing software
manufactured by Marshall & Swift/Boeckh and Xactware, the industry has
been able to standardize its tactics for low-balling claims, and create
a "tainted" database of claims settlements figures which the industry
uses to further depress estimates for what people need to repair their
homes, according to the lawsuit.. Meanwhile, all of this data is
centralized by Xactware's parent company, Insurance Services Office,
better known as ISO, allowing companies to collude.
Foti's suit was filed in conjunction
with Baton Rouge sole practitioner Joseph McKernan; New Orleans sole
practitioner Mark Glago; and the New Orleans law firms of Herman,
Herman, Katz & Cotlar and Capitelli & Wicker. Those firms are working
with Jane Johnson, Louisiana's assistant attorney general for anti-trust
issues, without any guarantees earning legal fees.
Prior to McKinsey's consulting work for
the industry, insurance was viewed as a quasi-public trust in which
insurance played a vital role in indemnifying the middle class against
financial ruin. But McKinsey, in its quest to increase profits for its
clients, ignored this unique function of the industry, and created a
devastating strategy that rewards shareholders at the expense of
policyholders that has spread throughout the industry, Berardinelli
says.
ISO brags in press releases that it has
a searchable database of more than 500 million insurance claims, and its
Xactware is used by 16 of the nation's top 20 property insurers. The
company's software allows insurers to monitor what claims adjusters are
doing through its XactAnalysis Quality Review and compare their work to
the latest prices reported in the software's Industry Trend Reports, and
allows insurers to assign reinspections. "In just a decade and a half, approximately a third of the insurers serving the United States vanished as escalating competition ate into top-line revenue growth and bottom-line profitability. But it isn't just the intensity of competition that's changing . . .The nature of the competition is changing, too, as advances in predictive modeling and other analytical techniques enable leading insurers of all sizes to target their marketing, underwriting and pricing as never before."
Claims adjusters, the suit says, are
pressured or required to accept the pricing database information from
the Xactware or Marshall & Swift/Boeckh software in the estimates they
write if the adjuster wants to be able to close the claim and get paid
for the work.
Meanwhile, the suit says that State Farm
has testified under oath that it can modify Xactimate's price lists
before adjusting claims. A pricing specialist conducts surveys building
material suppliers for the latest prices and updated its New Orleans
prices several times per quarter between 2005 and 2007. However, the
suit says, a State Farm price list containing 10,000 different items was
exactly the same as a Travelers price list on Nov. 15, 2005, something
that would be "a statistical impossibility without collusion."
Attorney General Charles Foti filed a lawsuit in Orleans Parish Civil District Court late Wednesday alleging collusion, price-fixing and anti-trust violations by six major insurance companies - including Allstate and State Farm - as well as the firms that manufacture their claims-processing software, and the companies that offer them advice or collect their data.
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